IDEAS home Printed from https://ideas.repec.org/a/eee/wodepe/v38y2025ics2452292925000220.html

Exploring health insurance as a financial buffer in Maternal and Child Health in the Democratic Republic of Congo

Author

Listed:
  • Biringanine, Alexis Nyamugira
  • Flessa, Steffen

Abstract

This study investigates the low health insurance coverage among pregnant women and new mothers in selected health zones of DRC, aiming to identify underlying factors and associated implications. The results from the sociodemographic analysis show that only 3% of our respondents reported having insurance coverage. This low coverage is primarily attributed to financial constraints, lack of information, and perceived low value relative to premium costs. The study revealed significant barriers to health insurance uptake, including inadequate health and insurance literacy. Without insurance, households often resort to coping strategies such as family support, informal borrowing, and reduced investment in children’s education. The study also highlights that enhanced health insurance literacy is positively associated with health insurance adoption and better health outcomes. Addressing low health insurance coverage requires targeted interventions to improve financial access and health literacy, and disseminate transparent information about insurance benefits. Implementing health insurance schemes could alleviate financial burdens, minimize reliance on informal networks, and improve health outcomes. Enhanced health insurance coverage, through effective communication and education, could substantially benefit socioeconomic conditions, particularly for mothers and children in the DRC.

Suggested Citation

  • Biringanine, Alexis Nyamugira & Flessa, Steffen, 2025. "Exploring health insurance as a financial buffer in Maternal and Child Health in the Democratic Republic of Congo," World Development Perspectives, Elsevier, vol. 38(C).
    • Handle: RePEc:eee:wodepe:v:38:y:2025:i:c:s2452292925000220
    DOI: 10.1016/j.wdp.2025.100677
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S2452292925000220
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.wdp.2025.100677?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to

    for a different version of it.

    References listed on IDEAS

    as
    1. David Byrne, 2022. "A worked example of Braun and Clarke’s approach to reflexive thematic analysis," Quality & Quantity: International Journal of Methodology, Springer, vol. 56(3), pages 1391-1412, June.
    2. Ivlabèhiré Bertrand Meda & Adama Baguiya & Valéry Ridde & Henri Gautier Ouédraogo & Alexandre Dumont & Seni Kouanda, 2019. "Out-of-pocket payments in the context of a free maternal health care policy in Burkina Faso: a national cross-sectional survey," Health Economics Review, Springer, vol. 9(1), pages 1-14, December.
    3. Hubert Amu & Kwamena Sekyi Dickson, 2016. "Health insurance subscription among women in reproductive age in Ghana: do socio-demographics matter?," Health Economics Review, Springer, vol. 6(1), pages 1-8, December.
    4. Maxwell Tii Kumbeni & Agani Afaya & Paschal Awingura Apanga, 2023. "An assessment of out of pocket payments in public sector health facilities under the free maternal healthcare policy in Ghana," Health Economics Review, Springer, vol. 13(1), pages 1-7, December.
    5. Islam, Asadul & Maitra, Pushkar, 2012. "Health shocks and consumption smoothing in rural households: Does microcredit have a role to play?," Journal of Development Economics, Elsevier, vol. 97(2), pages 232-243.
    6. Hebe N Gouda & Andrew Hodge & Raoul Bermejo III & Willibald Zeck & Eliana Jimenez-Soto, 2016. "The Impact of Healthcare Insurance on the Utilisation of Facility-Based Delivery for Childbirth in the Philippines," PLOS ONE, Public Library of Science, vol. 11(12), pages 1-15, December.
    7. Strupat, Christoph & Klohn, Florian, 2018. "Crowding out of solidarity? Public health insurance versus informal transfer networks in Ghana," World Development, Elsevier, vol. 104(C), pages 212-221.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Bagnoli, Lisa, 2019. "Does health insurance improve health for all? Heterogeneous effects on children in Ghana," World Development, Elsevier, vol. 124(C), pages 1-1.
    2. Garcia-Mandicó, Sílvia & Reichert, Arndt & Strupat, Christoph, 2021. "The Social Value of Health Insurance: Results from Ghana," Journal of Public Economics, Elsevier, vol. 194(C).
    3. David K Evans & Katrina Kosec, 2023. "Cash Transfers, Trust, and Inter-household Transfers: Experimental Evidence from Tanzania," The World Bank Economic Review, World Bank, vol. 37(2), pages 221-234.
    4. Naureen Akber Ali Meghani & Joanne Hudson & Gareth Stratton & Jane Mullins, 2023. "Older adults’ perspectives on physical activity and sedentary behaviour within their home using socio-ecological model," PLOS ONE, Public Library of Science, vol. 18(11), pages 1-24, November.
    5. Wonhyung Lee & Nurul Widyaningrum, 2019. "Multidimensional access to financial services: Insights from Indonesia," Progress in Development Studies, , vol. 19(1), pages 21-35, January.
    6. Islam, Asadul & Nguyen, Chau & Smyth, Russell, 2015. "Does microfinance change informal lending in village economies? Evidence from Bangladesh," Journal of Banking & Finance, Elsevier, vol. 50(C), pages 141-156.
    7. Singh, Nirvikar, 2018. "Financial Inclusion: Concepts, Issues and Policies for India," MPRA Paper 91047, University Library of Munich, Germany.
    8. Sowmya Dhanaraj, 2014. "Health Shocks and Coping Strategies: State Health Insurance Scheme of Andhra Pradesh, India," WIDER Working Paper Series wp-2014-003, World Institute for Development Economic Research (UNU-WIDER).
    9. Neelsen, Sven & Limwattananon, Supon & O'Donnell, Owen & van Doorslaer, Eddy, 2019. "Universal health coverage: A (social insurance) job half done?," World Development, Elsevier, vol. 113(C), pages 246-258.
    10. Kwame Adjei-Mantey & Charles Yuji Horioka, 2023. "Determinants of health insurance enrollment and health expenditure in Ghana: an empirical analysis," Review of Economics of the Household, Springer, vol. 21(4), pages 1269-1288, December.
    11. Mussa, Richard, 2017. "Long-term Effects of Early Life Maize Yield on Maize Productivity and Efficiency in Rural Malawi," MPRA Paper 75975, University Library of Munich, Germany.
    12. Arghya Kusum Mukherjee & Amit Kundu, 2012. "Swarnajayanti Gram Swarojgar Yojona as a Safety Net: Evidence from Murshidabad District of West Bengal," Bangladesh Development Studies, Bangladesh Institute of Development Studies (BIDS), vol. 35(1), pages 79-103.
    13. Weisong Qiu & Tieqi Wu & Peng Xue, 2022. "Can Mobile Payment Increase Household Income and Mitigate the Lower Income Condition Caused by Health Risks? Evidence from Rural China," IJERPH, MDPI, vol. 19(18), pages 1-15, September.
    14. Nikolov, Plamen & Bonci, Matthew, 2020. "Do public program benefits crowd out private transfers in developing countries? A critical review of recent evidence," World Development, Elsevier, vol. 134(C).
    15. Yidi Liu & Xin Li & Zhiqiang (Eric) Zheng, 2024. "Consequences of China’s 2018 Online Lending Regulation and the Promise of PolicyTech," Information Systems Research, INFORMS, vol. 35(3), pages 1235-1256, September.
    16. Bhatt, Om Prakash, 2023. "Roles and Scenario of Partly Qualified Actuaries in Insurance Companies of Nepal," OSF Preprints ue2xv, Center for Open Science.
    17. Atakorah, Yaw Boateng & Arthur, Eric & Osei-Fosu, Anthony Kofi & Novignon, Jacob, 2024. "Economic inequalities in health insurance subscription renewal: Evidence from Ghana's National Health Insurance Scheme," Social Science & Medicine, Elsevier, vol. 341(C).
    18. Pushkar Maitra & Sandip Mitra & Dilip Mookherjee & Alberto Motta & Sujata Visaria, 2014. "Helping Microfinance Fulfill its Promise: Raising Borrower Incomes through Agent-Intermediated Lending," HKUST IEMS Thought Leadership Brief Series 2015-03, HKUST Institute for Emerging Market Studies, revised Oct 2014.
    19. Sowmya Dhanaraj, 2015. "Health shocks and the intergenerational transmission of inequality: Evidence from Andhra Pradesh, India," WIDER Working Paper Series 004, World Institute for Development Economic Research (UNU-WIDER).
    20. Nazmul Islam, Muhammed & Rabbani, Atonu & De Allegri, Manuela & Sarker, Malabika, 2024. "Medical treatment loans and their effects on health care utilization and out-of-pocket expenditure: Evidence from an experiment in northern Bangladesh," World Development, Elsevier, vol. 184(C).

    More about this item

    Keywords

    ;
    ;
    ;
    ;

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:wodepe:v:38:y:2025:i:c:s2452292925000220. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: https://www.journals.elsevier.com/world-development-perspectives .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.